Division of Family PracticeThompson Region

Annual Report2010

Thompson Region Division of Family Practice 2010 Annual Report 3

An Opportunity for the Thompson Region A Leap of Faith

I am honoured to submit the Thompson Region Division of Family Practice inaugural report. The Division of Family Practice initiative aims to improve physician and patient experiences with primary care, to be cost effective and to improve population health. I believe that the initiative has given us an unprecedented opportunity and responsibility to positively impact primary care for the community in which we all live and work. As most of the Division board of directors had little or no prior experience in the set-up and operation of a non-profit society, we certainly faced challenges in forming the Division and creating community partnerships. At times, it has been tedious and laborious. At other times, it has been exciting and all-consuming. Managing this change has been a leap of faith – a leap supported by our partners, the Ministry of Health (MoH), the BC Medical Association (BCMA) and the Interior Health Authority (IHA).

On behalf of our members, I would like to take this opportunity to especially commend the steadfastness and goodwill of our 2010/2011 board of directors - Dr. Chip Bantock, Dr. Wayne Dong, Dr. Peter Gorman and Dr. Kraig Montalbetti. They have been committed, hardworking and have gone above and beyond the call of duty on many occasions.

The year ahead is rich in opportunity. This is especially the case given the MoH’s mandate to evolve health care supports around primary care offices and the response by the IHA requesting that family physicians provide input into its Community Integration. As a board, we seek to evaluate the opportunities while not asking physicians to work longer or harder. We will continue to maintain and improve upon the programs that we have started, as well as be responsive to membership needs and readiness to take on more challenges. Through the support of our membership I would like to see our division continue to develop into a robust organization. We also need to engage other community leaders to enable us to generate better services for our community in ways we have not been able to do within our own sphere of influence.

Dr. Brenda Hefford, one of the first physician leads for the White Rock-South Surrey Division of Family Practice, paraphrased well when she quoted an unknown source, “If you want to travel fast, travel alone but if you want to travel far, travel together.” I would like to extend an invitation to everyone to be part of this renaissance in family practice by providing input and working on projects that you are passionate about. Only through the strength and support of you, our members, will we be able to carry on and fulfill our mission.

Dr. Shirley SzePresident

Left - Thompson Region Division of Family Practice members and their patients participating in the BCMA Walk with your Doc event.

Thompson Region Division of Family Practice 2010 Annual Report4

History of the Thompson Region Division of Family Practice

The Thompson Region Division of Family Practice was incorporated in March 2010. The journey began almost a year prior in April 2009, when a dedicated group of family practitioners came together to contribute ideas about problems that they identified in the community. Issues included orphaned patients, locum support, care for mental health patients, primary care obstetrical issues, a family residency program, and a residential care plan. The MoH, BCMA and IHA participated in the initial presentation and through a process approved the application to form a division. The first group of physicians was given the responsibility of representing physician membership to improve health care in the community. In the initial document of intent, it was clear there was a potential to extend the division’s boundaries beyond Kamloops and include family physicians from smaller surrounding communities who may not have the resources to create a division of their own. With this in mind, the division was named the Thompson Region Division of Family Practice.

After the Division’s formal incorporation, an enthusiastic group of individuals stepped forward to form the board of directors. They hired a coordinator, Marcia Wilson. Marcia was instrumental in guiding the inaugural board through the initial set-up phase. A number of engagement activities were organized including a leadership workshop, a member survey and a ‘dotmocracy’ gathering, where attendees refined the priorities for the board to address in the near future.

The Division’s office functions as a dedicated space for the Division to hold its board, working group and CSC meetings.

Recruitment of Physician Members

To establish infrastructure funding for the Division to do its work, the Thompson Region Division board undertook a membership drive. It has been overwhelmingly successful. In the past year the Division has signed up 112 members out of a potential 114 in the area. Membership is inclusive of all full service family physicians, ER physicians, hospitalists and physicians with focused practices. This diversity in the membership is at the centre of all activities undertaken by the board. The Division leadership seeks to address the concerns of all groups.

Right - Thompson Division staff members (left to right) Sandy Taylor, bookkeeper, Dr. Shirley Sze, president, a patient from the local community and Jewel Calibaba, our interim administrative assistant.

Right - Thompson Division treasurer, Dr. Chip Bantock, walking with his patients as part of Walk with your Doc.

Thompson Division board members (left to right) Dr. Kraig Montalbetti, secretary, and Dr. Peter Gorman, vice-president

Board members Dr. Wayne Dong, director (left) and Dr. Chip Bantock, treasurer (right).

Thompson Region Division of Family Practice 2010 Annual Report 7

Addressing Issues in the Community

Since the hospitalist program was introduced at Royal Inland Hospital in 2008, family physicians have gradually but steadily shifted from active to associate hospital privileges. In October 2010, the Thompson Region Division of Family Practice board learned that another group of family physicians were considering withdrawing their hospital privileges if significant changes were not made to the hospital system. This prompted the Division’s first Collaborative Services Committee meeting in November 2010. The Division members who were affected by the hospital issues were gracious in giving members of the committee a six month timeline for the partners (MoH, IHA, and the BCMA) at the CSC to find a solution. One outcome of these CSC meetings is that a Hospital Systems Working Group was formed, which is actively examining and addressing the system problems. Their work will make the interface between the hospital and the family physicians that provide care much stronger. The Remuneration for In-Hospital Care Working Group was also set up, resulting in a Memorandum of Understanding to provide funding for family physicians to continue the work they have been doing for their own patients in hospital.

In addition, a Mental Health Working Group has been formed. This working group’s mandate is to provide family physicians with the information they need to access psychiatric and mental health services in a coordinated fashion, as well as to provide unattached mental health patients with access to primary care. Dr. Kurt Buller, Director of Psychiatric Services at Mental Health, will be an invited guest at the division’s Annual General Meeting, along with mental health team members. Dr Buller will present a report on the work he has done to enhance the seamless referral process for family physicians to access psychiatrists and mental health services for their patients.

As well, a number of family physicians are involved in co-designing a collaborative team-based primary care unit at King Street for the unattached mental health patients. They also provide input to a substance abuse/addiction medicine learning module for our members who wish to learn more about this area of practice.

A member of the Division has also demonstrated excellent leadership by creating a community call system for physicians who wish to provide care to their community patients, including those in long term and residential care. Part of this system can be linked to existing Residential Care Program contracts if the working group agrees to this and their objectives align.

In the coming year, the Thompson Region Division of Family Practice will undertake new initiatives to increase physician recruitment and retention. This will involve setting up locum services, exploring the Family Medicine Residency program alongside specialist colleagues, and looking at innovative ways to recruit new family physicians to local communities.

Far left - Division secretary, Dr. Kraig Montalbetti, and his family.

Left - Division board director, Dr. Wayne Dong, with a patient.

Thompson Region Division of Family Practice 2010 Annual Report8

Financial Statement

This consolidated Statement of Operations is based on an unaudited financial statement for the fiscal year ending March 31, 2011.

Expenditures

Physician costs $ 76,258.68

Lead, Board, CSC, Treasurer, Policy Committee, Hospital Physician Retention.

Coordinator $ 21,294.70

Admin Assistant $ 5,669.25

Leasehold $ 10,678.58

Infrastructure Funding Carry Forward $ 85,125.04

Income

Infrastructure when TRDFP took funds $ 224,995.00

Total Expenses $ 139,869.96

Total Expenses

Expenses

Net income

Expenses

Net income

Admin Assistant

Bookkeeper

Meeting Costs

Rent

Thompson Region Division of Family Practice 2010 Annual Report 9

Highlights of the Thompson Region Division

November 24, 2009 Document of intent signed between the Thompson Region family physicians, the General Practice Services Committee, Interior Health Authority and Health System Planning Division, Ministry of Health and the British Columbia Medical Association.

March 2010 Thompson Region Division of Family Practice incorporated as a non-profit society.

April 2010Coordinator, Marcia Wilson, is hired.

May 2010Survey of member priorities.

June 2010First membership engagement meeting with leadership workshop.

November 2010Formal launch of the Thompson Region Division of Family Practice. Dotmocracy method used to gather input about the priority issues of our members.

November 2010First Collaborative Services Committee meeting with Interior Health, Ministry of Health and the BCMA.

February – March 2011Development of the division’s office.

May 2011First memorandum of understanding discussion at CSC regarding support for continued in-hospital care of patients.

May 2011Walk with Your Doc event with board of directors, patients and staff.

May 2011First Annual General Meeting.

The Divisions of Family Practice initiative is sponsored by the General Practice Services Committee, a joint committee of the BC Ministry of Health and the BC Medical Association.

www.divisionsbc.ca

Division of Family PracticeThompson Region

Board of DirectorsDr. Shirley Sze, PresidentDr. Peter Gorman, Vice-PresidentDr. Chip Bantock, TreasurerDr. Kraig Montalbetti, SecretaryDr. Wayne Dong, Director

Thompson Region Division of Family Practice209, 310 Nicola StreetKamloops, BC. V2C 2P5

Photographs of the Kamloops area courtesy of PictureBC.com:Cover - alpine meadows at Sun Peaks Resort near Kamloops.Page 2 - hoodoos in the Thompson Valley.Page 7 - Kamloops beach.